Effect of immunochemotherapy administration sequence on efficacy and adverse reac-tions in patients with non-small cell lung cancer / 中国肿瘤临床

Objective:To explore the effect of chemotherapy administration sequence combined with programmed cell death protein-1(PD-1)monoclonal antibody on the efficacy and immune-related adverse events(irAEs)in patients with advanced non-small cell lung cancer(NSCLC).Methods:The clinical data of 110 patients with advanced NSCLC treated at The First Affiliated Hospital of Zhengzhou University between November 2019 and January 2022 were retrospectively collected.The factors influencing irAEs were analyzed by univariate and multivariate Logistic regression analyses,while those influencing curative effect were analyzed by Kaplan-Meier curve analysis,Log-rank test,and univariate and multivariate Cox regression analyses.Results:Treatment with PD-1 monoclonal antibody after 2 days of chemotherapy(sequential treatment group,n=36)significantly prolonged progression-free survival(PFS)compared with PD-1 monoclonal antibody admin-istration on the same day of chemotherapy(simultaneous treatment group,n=74)(17.2 months vs.11.3 months,respectively;P＜0.05).The disease control rate(DCR)was better in the sequential treatment group than in the simultaneous treatment group(94.4％vs.79.7％,re-spectively;P=0.045),while the objective response rate(ORR)did not differ significantly(69.4％vs.51.4％,respectively;P=0.072).The Cox re-gression analysis showed that cytokerat in 19 fragment(Cyfra21-1)and d-dimer(D-dimer)affected the efficacy of combination therapy(P＜0.05).The Logistic regression analysis showed that age and lactic dehydrogenase(LDH)influenced the occurrence of irAEs(P＜0.05),while the administration sequence did not significantly affect the occurrence of irAEs(P=0.130).Conclusions:Administration sequence influences the efficacy of combination therapy,and patients with advanced NSCLC who receive sequential therapy may experience better efficacy.Age and LDH are negatively correlated with the occurrence of irAEs.

Preliminary experience of neoadjuvant immunochemotherapy in resectable non-small cell lung cancer / 中华胸心血管外科杂志

Objective:The study aimed was to explore the safety and efficacy of neoadjuvant immunochemotherapy for non-small cell lung cancer (NSCLC).Methods:We retrospectively collected data of all patients who received neoadjuvant immunochemotherapy and chemotherapy for NSCLC followed by surgery in our unit between January 2019 to September 2021.Results:Forty-four patients were diagnosed with NSCLC in a stageⅠ(2 cases), ⅡA(7 cases), ⅡB(11 cases), ⅢA (15 cases), ⅢB (1 case). The average age was 63 years old(range 44-71 years old). Squamous cell carcinoma accounted for 65.91% of all patients. Central lung cancer accounted for the vast majority, with 39 patients (88.64%). There were 19 cases in the neoadjuvant immunochemotherapy group and 25 cases in the neoadjuvant chemotherapy group; the average interval between the end of neoadjuvant therapy and the day of operation was 34 days, including( 33.74±10.66 )days in the immunochemotherapy group and (33.88±11.9) days in the chemotherapy group, and there was no significant difference between the two groups. No grade 3 or more adverse events occurred in all patients. There were 13 cases (63.16%) reached PR (partial response)+ CR (complete response) according to the Response Evaluation Criteria in Solid Tumors (RECIST v. 1.1) in the neoadjuvant immunity group and 11 cases (44.00%) in the neoadjuvant chemotherapy group. There was no significant difference between the two groups. In the neoadjuvant immunochemotherapy group, 9 cases (47.37%) achieved down-staging, In the neoadjuvant chemotherapy group, 8 cases (32.00%) achieved down-staging, there was no significant difference between the two groups. Seven patients (36.84%) in neoadjuvant immunochemotherapy group showed pCR (pathologic complete remission), but there were no patients who reached pCR in the neoadjuvant chemotherapy group., the difference was statistically significant ( P=0.001). Four patients (21.05%) in the neoadjuvant immunochemotherapy group reached mPR (major pathologic response), 6 patients (24.00%) in the neoadjuvant chemotherapy group reached mPR, and the difference was no statistically significant( P= 0.817). Conclusion:The safety of neoadjuvant immunochemotherapy was satisfactory; Compared with neoadjuvant chemotherapy, neoadjuvant immunochemotherapy did not increase the preoperative grade 3 adverse events and prolong the waiting time before operation; neoadjuvant immunochemotherapy had obvious advantages in pCR, which provided the possibility for the cure of tumor.

Case Analysis of the Participation of Clinical Pharmacists in Immunochemotherapy Regimen for a Follicular Lymphoma Patient with Hepatitis C / 中国药房

OBJECTIVE:To explore the role of clinical pharmacists on immunochemotherapy for follicular lymphoma patients with hepatitis C. METHODS:Clinical pharmacists participated in the treatment process for a follicular lymphoma patient with hepatitis C. Clinical pharmacist suggested patient to initially take liver protection,white blood cell and platelet increasing therapy, and take rituximab immunochemotherapy after liver function and hemogram improved. During treatment,liver function and hepatitis C virus RNA(HCV-RNA)load should be monitored closely.After the completion of immunochemotherapy,the patient's lymphoma was completely relieved and then anti-HCV treatment could be considered. RESULTS:Physicians adopted the suggestions of clinical pharmacists,and prescribed intravenous dripping of rituximab 600 mg to the patient. The immunochemotherapy was carried out smoothly,the patient didn't feel discomfort and then discharged from hospital. CONCLUSIONS:The participation of clinical pharmacists in the formulation of individual medication plan,which promotes rational drug use and guarantee the safety of drug use.

Factors Modulating Responses to Immunochemotherapy in Advanced Renal Cell Carcinomas / 대한비뇨기과학회지

PURPOSE: Despite numerous trials no various immunochemotherapeutic agents, advanced renal cell carcinomas (RCC) remain highly resistant to treatment. We report the results of immunochemotherapy to evaluate its efficacy, and to investigate factors modulating responses to treatment. MATERIALS AND METHODS: In this retrospective analysis, 54 patients with advanced RCC, having received either interferon-alpha (IFN-alpha) monotherapy, or a combination of interleukin-2 (IL-2), 5-fluorouracil (5-FU) and vinblastine, with IFN-alpha between January 1999 and March 2001, were reviewed. The patients were divided into 2 groups, either single or combined, therapy groups, which were further subdivided into locally advanced and metastatic disease groups. The nephrectomy and performance stati, cancer stage at the beginning of the immunotherapy, metastasized organs and interval to metastasis, were considered, and the responses to treatment and survival were evaluated accordingly in each subgroup. RESULTS: Of the 54 patients, 39 received monotherapy, 34 of which had a metastatic disease. Partial remission was observed in 1 patient (2.9%) with a duration of response of 52 weeks, a median survival of 47 weeks (4-323 wks) and a 1 year survival rate of 41.2%. Of the 15 patients in the combined therapy group, 12 with a metastatic disease, complete remission was noted in 1 patient (8.3%), with a continuous response at 57 weeks, a median survival of 34 weeks (4-204 wks) and a 1 year survival rate 41.7%. Of the prognostic factors, the nephrectomy status proved to be the only significant factor improving survival. CONCLUSIONS: Advanced RCC exhibited a very limited response, and nephrectomy status was revealed to be the only significant factor affecting survival. The efficacy of immunotherapy on locally advanced RCC needs further controlled evaluative studies.

Clinical study on the preventive effect of high-dose immuno-chemotherapy on the recurrence and metastasis of renal cell carcinoma / 中华泌尿外科杂志

Objective To study the preventive effect of high-dose immuno-chemotherapy on the recurrence and metastasis of renal cell carcinoma(RCC). Methods Overall 18 patients with RCC(13 men and 5 women;mean age,56 years,range,37 to 78 years) underwent radical nephrectomy.These cases were assigned to 2 groups.①Immuno-chemotherapy group included 13 cases (10 men and 3 women),whose tumor stages were T 1 (1 case),T 2 (8) and T 3(4).They were treated with high-dose subcutaneous interleukin-2(IL-2) in combination with interferon-?(IFN-?) and venous infusion 5-fluorouracil(5-Fu) 10 days after operation.②Control group included 5 cases (3 men and 2 women),whose tumor stages were T 1(1 case),T 2(3),T 3(1).They didn’t receive immuno-chemotherapy.The immuno-chemotherapeutic courses consisted of IL-2 (8?10 6 U,3 times/w,weeks 1 and 4;4?10 6 U,3 times/w,weeks 2 and 3);IFN-? 6?10 6 U,3 times/w,weeks 2,3,6 and 7;9?10 6 U,3 times/w,weeks 5 and 8);and 5-Fu (1000 to 1250 mg,once a week,weeks 5 to 8).Such therapeutic cycle could be repeated at 3-month intervals.Follow-up was conducted with hemogram,hepatic and renal function,ultrasonography of liver and kidney,chest X-ray every month after treatment.Long-term outcomes for these patients were analyzed. Results Follow-up of 60 to 87 months was carried out after 1 to 4 therapeutic cycles(mean,1.9 cycles) in the 13 cases of immuno-chemotherapy.Of them,12 cases experienced cancer-free survival.Only 1 case had metastasis in thigh bone 43 months after operation.No severe side effects occurred.5 cases in control group were found with metastasis in 3 to 14 months after operation.The mean survival of control group was 12.8 months (range,6 to 21 months). Conclusions Immuno-chemotherapy with high-dose subcutaneous IL-2 in combination with IFN-? and venous infusion of 5-Fu is safe and effective in prevention of the recurrence and metastasis of RCC.

Effects of Adjuvant Immunochemotherapy in Stage III Gastric Cancer

BACKGROUND: To evaluate the effectiveness of early postoperative adjuvant immunochemotherapy in a stage III (UICC, 1997) primary gastric carcinomas we analyzed cases histories of 140 patients retro spectively who had undergone curative gastrectomy at Wonkwang University Hospital from November 1988 to November 1995. METHODS: For immunotherapy, OK-432 intramuscularly or oral PSK was used for 2 months, and for chemotherapy, FAM (8 week cycle) or oral 5-FU derivatives and MMC were used for 6 months or longer. Immunotherapy was started at the 5th postoperative day and chemotherapy at the 7th to 10th postoperative day. Sixty-eight (68) patients received immunochemotherapy (therapy group; TG) and 72 patients did not (nontherapy group; NTG). Statistical analysis were carried out with Anova, Kaplan-Meier, and Log rank test. RESULTS: One hundred eight (108) patients were male, and 84 patients were younger than 60 years. Eighty-one (81) cases involves the lower stomach and 52 the middle stomach. Lymphatic invasion was seen in 60 cases. Twenty-five (25) cases were T2, 112 T3, 42 N1, 90 N2, 75 stage IIIa, and 65 stage IIIb. The overall 5-year survival rate was 48.6% (stage IIIa 58.7%, stage IIIb 36.9%, p<0.05). The 5-year survival rates for the TG and the NTG were 52.9% and 44.4%, respectively (p=0.10). The 5-year survival rates were 85.7% (n=18) and 85.7% (n=7) in T2, 54.0% (n=50) and 40.3% (n=62) in T3 (p<0.05), 69.6% (n=23) and 50.0% (n=24) in N1, 44.4% (n=45) and 42.2% (n=45) in N2 (p=0.14), 61.0% (n=41) and 55.9% (n=34) in stage IIIa, 40.7% (n=27) and 34.2% (n=38) in stage IIIb (p=0.16), 59.5% (n=37) and 48.8% (n=43) in the non-lymphatic invasion group, and 45.2% (n=31) and 37.9% (n=29) in the lymphatic invasion group (p=0.09). There was no significant difference in the 5-year survival rates of the other parameters, such as age, sex, tumor location, size, gross finding, tumor differentiation, between the TG and the NTG. CONCLUSION: The survival rate in the early postoperative immunochemotherapy group was not signi ficantly increased compared to that in the nontherapy group for stage III gastric cancer, but the immuno chemotherapy group showed a tendency for a higher 5-year survival than the nontherapy group did.

The lymphangial immunochemotherapy of the advanced gastric carcinoma before and after the operation / 临床外科杂志

Objective To study the action of the lymphangial immunochemotherapy on the advanced stomach cancer. Methods Group of therapy: To inject the chemotherapeutic medicine and biological response modifiers (BRM) absorbed by active carbon through the stomach mucosa by means of gastroscope and through the stomach serosa by means of surgical operation. Group of contrast: To inject the aqueous solution of the chemotherapeutic medicine and BRM through the arteria femoralis by means of the intervention. Then we examined the immune activity of the blood cell.Results There is a marked difference between the lymphangial immunochemotherapy and the blood immunochemotherapy in the immune activity of the blood cell. Conclusion The lymphangial immunochemotherapy can promote the apoptosis of the transferred cancer in the lymph system and enhance the immune activity of the blood cell.

Effect of Adjuvant Immunochemotherapy on Immunologic Function of Gastric Cancer Patients

BACKGROUND: We have postoperatively performed adjuvant immunochemotherapy (Picibanil plus oral -fluorouracil) for advanced gastric cancer patients. We aimed to study the effect of immunochemotherapy on the immunologic function after gastric resection for advanced gastric cancer patients. METHODS: Twenty gastric cancer patients were randomly selected at the outpatient department from May 1994 to September 1994. All patients had undergone a total gastrectomy with a D2 lymph node dissection (at least) and had also undergone adjuvant immunochemotherapy for two years. No patients had any evidence of a local recurrence or a distant metastasis at the time of the study. The immunologic parameters were the total lymphocyte count and the percentages of T3 cells (CD3), T4 cells (CD4) and T8 cells (CD8), which were determined using monoclonal antibodies and flow cytometry. A delayed skin hypersensitivity reaction was induced with dinitrochlorobenzene (DNCB). These parameters before operation were compared with those after immunochemotherapy. RESULTS: The average total lymphocyte count before the operation showed no significant difference from that after immunochemotherapy (2,138+127.9/ml vs. 2,235.7+140.0/ml, respectively). The average proportions of T3, T4, and T8 cells among the lymphocytes also showed no significant difference (59.0+2.2%, 36.9+1.5%, and 25.8+1.5%, preoperatively, vs. 61.3+3.2%, 39.7+2.7%, and 23.4+1.8%, after immunochemotherapy, respectively). The distribution of the delayed skin hypersensitivity reactions of the patients was not significantly different from that of the normal control group. CONCLUSIONS: The postoperative immunological function was not suppressed by immunochemotherapy. This suggests that a long-term immunotherapy combined with chemotherapy might play a role in supporting immunologic functions after a gastric resection.